Stephen Fomba: Shoes might reduce ebola outbreaks

Growing up in Konjo village in the Eastern Province of Sierra Leone, I remember the walks. Long, cold morning walks to the farms. The daily trek to and from school.

I didn't mind growing up this way. But I hated having to make these walks barefoot because we couldn't afford shoes. I sustained burns from the hot ground and rocks; wounds from sharp stones, thorns and even broken bottles; infections from unknown bacteria, and various ailments — red skins, open sores that took very long to heal, fevers. Even when hurt or ill, I had to keep walking, often as many as 20 miles a day, usually under a hot sun.

We rarely think about the perils of walking barefoot. But according to one widely cited estimate, some 300 million children don't have shoes. Many illnesses and infections come from the ground, through stepping on sharp objects, or touching saliva, blood or bodily fluids. And it's not merely those who can't afford shoes who go barefoot; many millions of people around the world own poor quality shoes, but have to be careful not to overuse them to avoid early wear and tear. Shoes are for special occasions.

I no longer walk barefoot because my situation is better now; I live in the U.S., where I work as a manager for a homeless program and am completing my doctorate in public administration. I arrived here in 1996, the end of a journey of escape from the long, brutal civil war that destroyed my beautiful country. I was among the first refugees in 1991 to cross the Makona River to neighboring Guinea seeking refuge from the rebels. I was just 9 years old at the time, and fled with my father. (My mother was not around). Despite the challenges in Guinea, I was relieved to have escaped. One thing that made me happy was the pair of shoes that a U.N. worker provided me at our refugee camp in Guinea.

We left Guinea after a short stay and crossed back over the border to Freetown, where we had relatives. My country's capital city was the safest place in Sierra Leone back then because of its western location — the war was raging in the east. I expected Freetown to be a more prosperous place, but was disappointed to see children and adults walking barefoot as many do in the villages. I sat in class with students who did not have shoes. I settled in Freetown and found myself playing soccer and other games barefoot with the other children. Consequently, our toes and the soles of our feet sustained many wounds, which became infected and led to swelling, pain, and the discharge of too much pus to recall here.

Today I think about those feet, and about barefoot children as I mourn, from the comfort of the U.S., those who have died from the Ebola virus in Sierra Leone, as well as in Liberia and Guinea. And I can't help but worry that barefoot walking is contributing to the spread of Ebola in that region, as well as other contagious viruses, including Hepatitis A and C, that are transmitted through contact with blood and other bodily fluids.

My concern is personal. My hometown is in the area that has been hardest hit by the Ebola virus. (I am in contact with my family but have not been back to visit since 2007). And the Kissi people (my tribe) are the majority in the places in all three countries where Ebola has broken out: the Kissi Chiefdoms in Kailahun, Sierra Leone; Gueckedou, Guinea; and Lofa County, Liberia. Are barefoot walkers, I wondered, coming in contact with Ebola-positive body fluids on the grounds they tread upon? People are always spitting out saliva. If an Ebola-positive person walks around barefoot, steps on a sharp object, and bleeds, he or she would easily spread the virus. And if an Ebola-negative barefoot walker steps on an Ebola-positive saliva or blood, that barefoot walker would unknowingly become infected. I'm not sure how much barefoot walking is contributing to the spread of the virus right now, but a virologist confirmed my hypothesis.

Controlling the Ebola outbreak is a complex, global effort. But at the local level, we could start with something very basic, but very important. Providing shoes to barefoot walkers would make them safer and healthier. It also might save us.

Stephen Fomba is program manager at the San Gabriel Valley Consortium on Homelessness. This opinion column was written in partnership with Zocalo Public Square.